Sorption, solubility, shrinkage and mechanical properties of “low-shrinkage” commercial resin composites

Effect of Artificial Aging Protocols on Surface Gloss of Resin Composites

The purpose of this study was to evaluate the effect of aging protocols on surface gloss of composites. Cylindrical resin composite specimens (6 mm in diameter, 1 mm thick) were fabricated and divided into three groups (N = 60): microfilled (MiFi), nanohybrid (NaHy), and nanofilled (NaFi). Specimens were distributed into four aging subgroups: thermocycling (5° to 55°C, 15,000 cycles); ethanol immersion (15 days); brushing (10,750 cycles); and light aging (216 h). Surface gloss readings (Novo-Curve, Rhopoint TM, England) were performed at baseline (R0) and after every one-third of aging protocols (R1 to R3). Data were submitted to one-way repeated measures ANOVA and Tukey's test (5%). Overall, surface gloss alterations were detected over time (p < 0.001). Thermocycling reduced surface gloss, except for NaHy. Ethanol immersion resulted in surface gloss reduction after R1 for MiFi and NaFi, while reduction after R1 and R2 was detected for NaHy. For brushing, gloss reduction was detected after R1 and R3 for all composites. For light aging, gloss was reduced after R1 and R2 for MiFi and NaFi, while a reduction only after R1 was detected for NaHy. The studied aging protocols affect surface gloss differently, being material and aging therapy dependent. In general, the surface gloss is reduced with aging.

Cytotoxicity of Light-Cured Dental Materials according to Different Sample Preparation Methods

Dental light-cured resins can undergo different degrees of polymerization when applied in vivo. When polymerization is incomplete, toxic monomers may be released into the oral cavity. The present study assessed the cytotoxicity of different materials, using sample preparation methods that mirror clinical conditions. Composite and bonding resins were used and divided into four groups according to sample preparation method: uncured; directly cured samples, which were cured after being placed on solidified agar; post-cured samples were polymerized before being placed on agar; and “removed unreacted layer” samples had their oxygen-inhibition layer removed after polymerization. Cytotoxicity was evaluated using an agar diffusion test, MTT assay, and confocal microscopy. Uncured samples were the most cytotoxic, while removed unreacted layer samples were the least cytotoxic (p < 0.05). In the MTT assay, cell viability increased significantly in every group as the concentration of the extracts decreased (p < 0.05). Extracts from post-cured and removed unreacted layer samples of bonding resin were less toxic than post-cured and removed unreacted layer samples of composite resin. Removal of the oxygen-inhibition layer resulted in the lowest cytotoxicity. Clinicians should remove unreacted monomers on the resin surface immediately after restoring teeth with light-curing resin to improve the restoration biocompatibility.

Effect of low shrinkage monomers on physicochemical properties of dental resin composites

The aim of this study was to evaluate the effect of low shrinkage monomers on physicochemical properties of dental resin composites. Two low shrinkage resin composites: one with a crosslink branching monomer (Kalore, GC Corp) and a novel monomer (Venus Diamond, Heraeus Kulzer) were compared to a conventional resin composite formulation (Filtek Z250, 3M/ESPE). The volumetric shrinkage was evaluated by µCT analysis (n=5) and the physicochemical properties by degree of C=C conversion (DC), flexural strength (FS) and Young's modulus (YM) (n=10). All samples were light cured by a LED device (Radii, SDI) with 16 J/cm2. The results were analysed by one-way ANOVA and Tukey test for multiple comparisons (α=0.05). No statistical difference was found between µCT shrinkage values to Kalore (1.8%) and Venus Diamond (1.7%) (p≥0.05); Z250 presented statistical highest shrinkage value (2.0%). Kalore presented higher statistical DC (60.8%) than Venus Diamond (49.5%) and Z250 (49.6%). No statistical difference was found between FS or YM properties to Venus Diamond and Z250; Kalore presented statistical lowest FS and YM properties (p≥0.05).

CONCLUSION

Using novel monomers seem to reduce polymerization shrinkage without affecting the physicochemical properties evaluated of resin composites rather than using crosslink branching monomers.

Bacterial microleakage of temporary filling materials used for endodontic access cavity sealing

Background/purpose

Providing a tight coronal seal is key for the success of endodontic treatment, therefore the study aimed to assess bacterial microleakage of materials used for short- and long-term temporization.

Materials and methods

One hundred and twenty-eight human upper-third molars were divided into six experimental groups (n = 20) and two control groups: negative (n = 4) and positive (n = 4). The standardized access cavities were prepared and filled with: (1) Cavit; (2) Fuji II LC; (3) Fuji IX; (4) Voco Clip; (5) AdheSE and Tetric EvoCeram; (6) Excite and Tetric EvoCeram. The crown of each tooth was sectioned to obtain 5.5-mm-high disks, which were assembled in a standard setup for bacterial microleakage studies using Streptococcus mutans. The monitoring lasted 90 days. Kaplan-Meier survival analysis was performed.

Results

The lowest amount of leaking samples was found in AdheSE and Tetric EvoCeram (31.3%), Cavit (33.3%), and Excite and Tetric EvoCeram groups (35.3%), followed by Fuji II LC (66.7%), Voco Clip (83.3%). and Fuji IX (88.2%) groups. According to the day of microleakage, materials could be classified in three groups with statistically significant differences (P < 0.05). In the first group were Cavit (70 days), AdheSE and Tetric EvoCeram (68 days), and Excite and Tetric EvoCeram (65 days), in the second group were Voco Clip (44 days) and Fuji II LC (43 days), and in the third group was Fuji IX (21 days).

Conclusion

None of the tested materials were able to completely prevent bacterial microleakage. Adhesively bonded composites and Cavit offer better sealing compared with glass ionomer cements, resin modified glass ionomer cements, and composites without the use of an adhesive system.

Clinical Evaluation of Silorane and Nano-hybrid Resin Composite Restorations in Class II Cavities up to 3 Years

In this study, the clinical performance of a silorane-based resin composite (SC) vs a nano-hybrid resin composite (NHC) was evaluated in Class II cavities. From January 2012 to February 2013, a total of 29 patients (eight men, 21 women; mean age, 24 ± 5 years) received 29 pairs of restorations using both SC (Filtek Silorane, 3M ESPE) and NHC (Filtek Z550, 3M ESPE) materials. Patients were followed until February 2015. One operator performed all restorations using the corresponding adhesive resins according to the manufacturers' instructions. Two calibrated independent examiners evaluated the restorations at one week, six months, and then annually using the modified United States Public Health Service (USPHS) criteria for anatomic form, marginal adaptation, color match, surface roughness, marginal discoloration, secondary caries, and postoperative sensitivity. Changes in the USPHS parameters were analyzed with the McNemar test (α=0.05). The mean observation period was 31.2 months. Marginal adaptation was the only parameter that showed a significant difference and was worse for SC than NHC (p=0.012). At the final recall, 17 restorations from the SC group and five from the NHC group received a score of 1 (explorer catches). These scores were significantly different between baseline and final recall for SC (p&lt;0.001) but not for NHC (p&gt;0.05). Both NHC and SC performed similarly in Class II restorations up to three years except for marginal adaptation, for which the latter demonstrated significant deterioration at the final recall compared with baseline.

Self-adhesive resin cements: pH-neutralization, hydrophilicity, and hygroscopic expansion stress

OBJECTIVES

The objective of the study was to investigate the relationship between pH-neutralization, hydrophilicity, and free hygroscopic expansion stress of self-adhesive resin cements (SARCs) after storage in artificial saliva.

MATERIALS AND METHODS

The SARCs RelyX Unicem Automix 2 (RX2, 3 M ESPE), iCEM (iCEM, Heraeus) and Maxcem Elite (MCE, Kerr) were under investigation in this study. Cylinders (height × diameter, 6 × 4mm) were prepared from each material and stored in artificial saliva (7d at 37 °C). Cylinder height was measured at baseline and after 7 days. After storage, the compression modulus was measured to calculate the free hygroscopic expansion stress. For pH-neutralization and hydrophilicity assessment, disks (height × diameter, 1 × 1.5 mm) were prepared, covered with electrolyte, and monitored over 24 h at 37 °C. Hydrophilicity was assessed using the static sessile drop technique at baseline and at different time intervals up to 24 h. Data were analyzed using one-way ANOVA and post hoc Student-Newman-Keuls test (S-N-K, α = 0.05).

RESULTS

After 24 h, RX2 (pH_24h 4.68) had a significantly higher (p < 0.05) pH-value than MCE (pH_24h 4.2) and iCEM (pH_24h 3.23). iCEM showed the significantly highest hydrophilicity (p < 0.05) after 24 h (θ_24h 85.02°), while MCE resulted lower (θ_24h 113.01°) in comparison with RX2 (θ_24h 108.11°). The resulting hygroscopic expansion stress of iCEM (29.15 MPa) was significantly higher (p < 0.05) compared to RX2 (14.5 MPa) and MCE (21.02 MPa).

CONCLUSIONS

The material with lowest pH-neutralization capacity displayed higher hydrophilicity after 24 h and higher hygroscopic expansion stress after 7 days compared to those with high pH-neutralization.

CLINICAL SIGNIFICANCE

Remnant hydrophilicity due to low pH-neutralization of SARCs could lead to cement interface stress build-up and long-term failure of silicate ceramic restorations.

Longevity of direct and indirect resin composite restorations in permanent posterior teeth: A systematic review and meta-analysis

OBJECTIVES

The aim of this systematic review and meta-analysis was to assess the differences in clinical performance in direct and indirect resin composite restorations in permanent posterior teeth.

SOURCES

PubMed, the Cochrane Library, Web of Science, Scopus, LILACS, BBO, ClinicalTrials.gov and SiGLE were searched without restrictions.

STUDY SELECTION

We included randomized clinical trials (RCTs) that compared the clinical performance of direct and indirect resin composite restorations in Class I and Class II cavities in permanent teeth, with at least two years of follow-up. The risk of bias tool suggested by Cochrane Collaboration was used for quality assessment.

DATA

After duplicate removal, 912 studies were identified. Twenty fulfilled the inclusion criteria after the abstract screening. Two articles were added after a hand search of the reference list of included studies. After examination, nine RCTs were included in the qualitative analysis and five were considered to have a 'low' risk of bias. The overall risk difference in longevity between direct and indirect resin composite restorations in permanent posterior teeth (p>0.05) at five-year follow-up was 1.494 [0.893-2.500], and regardless of the type of tooth restored, that of molar and premolars was 0.716 [0.177-2.888] at three-year follow-up.

CONCLUSIONS

Based on the findings, there was no difference in longevity of direct and indirect resin composite restorations regardless of the type of material and the restored tooth.

CLINICAL SIGNIFICANCE

Contemporary dentistry is based on minimally invasive restorations. Any indication of a less conservative technique must have unquestionable advantages. In vitro and in vivo studies reveal contradictory evidence of the clinical performance of direct and indirect resin composite restorations in posterior teeth. Thus this study clarified this doubt.

Influence of water immersion on the mechanical properties of fiber posts

PURPOSE

The purpose of this study was to evaluate the influence of water immersion on the mechanical properties of three kinds of glass fiber posts and the fracture resistance of structures using resin composites with glass fiber posts.

METHODS

Each post was divided into three groups; a control group and two water immersion groups (30 and 90 days). Flexural strength was determined by three-point bending test. Each structure was divided into two groups; a control group and a water immersion group for 30 days. The fracture strength of structures was determined by a static loading test.

RESULTS

In the flexural strength, two kinds of post in water immersion groups showed lower values than control groups. In the fracture strength, two kinds of structures in water immersion group showed lower values than control groups.

CONCLUSION

The prefabricated glass fiber posts and structures using resin composites with glass fiber posts were affected by water immersion.

Polymerization shrinkage kinetics and shrinkage-stress in dental resin-composites

OBJECTIVES

To investigate a set of resin-composites and the effect of their composition on polymerization shrinkage strain and strain kinetics, shrinkage stress and the apparent elastic modulus.

METHODS

Eighteen commercially available resin-composites were investigated. Three specimens (n=3) were made per material and light-cured with an LED unit (1200mW/cm(2)) for 20s. The bonded-disk method was used to measure the shrinkage strain and Bioman shrinkage stress instrument was used to measure shrinkage stress. The shrinkage strain kinetics at 23°C was monitored for 60min. Maximum strain and stress was evaluated at 60min. The shrinkage strain rate was calculated using numerical differentiation.

RESULTS

The shrinkage strain values ranged from 1.83 (0.09) % for Tetric Evoceram (TEC) to 4.68 (0.04) % for Beautifil flow plus (BFP). The shrinkage strain rate ranged from 0.11 (0.01%s(-1)) for Gaenial posterior (GA-P) to 0.59 (0.07) %s(-1) for BFP. Shrinkage stress values ranged from 3.94 (0.40)MPa for TET to 10.45 (0.41)MPa for BFP. The apparent elastic modulus ranged from 153.56 (18.7)MPa for Ever X posterior (EVX) to 277.34 (25.5) MPa for Grandio SO heavy flow (GSO).

SIGNIFICANCE

The nature of the monomer system determines the amount of the bulk contraction that occurs during polymerization and the resultant stress. Higher values of shrinkage strain and stress were demonstrated by the investigated flowable materials. The bulk-fill materials showed comparable result when compared to the traditional resin-composites.

Effect of Restorative System and Thermal Cycling on the Tooth-Restoration Interface – OCT Evaluation

The present study evaluated the tooth/noncarious cervical lesion restoration interface when using different adhesive systems and resin composites, submitted to thermal cycling (TC), using optical coherence tomography (OCT). Noncarious cervical lesion (NCCL) preparations (0.7 mm depth × 2 mm diameter) were performed on 60 human third molars and randomly divided into six groups, according to the adhesive system and resin composite used: group 1 = Adper Single Bond 2 (SB2) + Aelite LS Posterior (AP); group 2 = SB2 + Venus Diamond (VD); group = SB2 + Filtek Z250XT (Z250); group 4 = Clearfil SE Bond (CSE) + AP; group 5 = CSE + VD; group 6 = CSE + Z250. Selective enamel etching was performed for 30 seconds on groups 4, 5, and 6, while groups 1, 2, and 3 were etched for 30 seconds in enamel and 15 seconds in dentin. All groups were evaluated using OCT before and after TC (n=10). Images were analyzed using Image J software; enamel and dentin margins were separately evaluated. Data from OCT were submitted to PROC MIXED for repeated measurements and Tukey Kramer test (α = 0.05). No marginal gaps were observed in etched enamel, either before or after TC, for all adhesive and resin composite systems. A significant interaction was found between adhesive system and TC for the dentin groups; after TC, restorations with CSE showed smaller gaps at the dentin/restoration interface compared with SB2 for all resin composites. Increased gap percentages were noticed after TC compared with the gaps before TC for all groups. In conclusion, TC affected marginal integrity only in dentin margins, whereas etched enamel margins remained stable even after TC. Dentin margins restored with CSE adhesive system showed better marginal adaptation than those restored with SB2. Resin composites did not influence marginal integrity of NCCL restorations.

Development of dental composites with reactive fillers that promote precipitation of antibacterial-hydroxyapatite layers

The study aim was to develop light-curable, high strength dental composites that would release calcium phosphate and chlorhexidine (CHX) but additionally promote surface hydroxyapatite/CHX co-precipitation in simulated body fluid (SBF). 80 wt.% urethane dimethacrylate based liquid was mixed with glass fillers containing 10 wt.% CHX and 0, 10, 20 or 40 wt.% reactive mono- and tricalcium phosphate (CaP). Surface hydroxyapatite layer thickness/coverage from SEM images, Ca/Si ratio from EDX and hydroxyapatite Raman peak intensities were all proportional to both time in SBF and CaP wt.% in the filler. Hydroxyapatite was, however, difficult to detect by XRD until 4 weeks. XRD peak width and SEM images suggested this was due to the very small size (~10 nm) of the hydroxyapatite crystallites. Precipitate mass at 12 weeks was 22 wt.% of the sample CaP total mass irrespective of CaP wt.% and up to 7 wt.% of the specimen. Early diffusion controlled CHX release, assessed by UV spectrometry, was proportional to CaP and twice as fast in water compared with SBF. After 1 week, CHX continued to diffuse into water but in SBF, became entrapped within the precipitating hydroxyapatite layer. At 12 weeks CHX formed 5 to 15% of the HA layer with 10 to 40 wt.% CaP respectively. Despite linear decline of strength and modulus in 4 weeks from 160 to 101 MPa and 4 to 2.4 GPa, respectively, upon raising CaP content, all values were still within the range expected for commercial composites. The high strength, hydroxyapatite precipitation and surface antibacterial accumulation should reduce tooth restoration failure due to fracture, aid demineralised dentine repair and prevent subsurface carious disease respectively.

Conversion, shrinkage, water sorption, flexural strength and modulus of re-mineralizing dental composites

OBJECTIVES

Cure, volumetric changes and mechanical properties were assessed for new dental composites containing chlorhexidine (CHX) and reactive calcium phosphate-containing (CaP) to reduce recurrent caries.

METHODS

20wt.% of light curable urethane dimethacrylate based liquid was mixed with 80wt.% glass filler containing 10wt.% CHX and 0-40wt.% CaP. Conversion versus depth with 20 or 40s light exposure was assessed by FTIR. Solidification depth and polymerization shrinkage were determined using ISO 4049 and 17304, respectively. Subsequent volume expansion and biaxial flexural strength and modulus change upon water immersion were determined over 4 weeks. Hydroxyapatite precipitation in simulated body fluid was assessed at 1 week.

RESULTS

Conversion decreased linearly with both depth and CaP content. Average solidification depths were 4.5, 3.9, 3.3, 2.9 and 5.0 with 0, 10, 20, and 40% CaP and a commercial composite, Z250, respectively. Conversions at these depths were 53±2% for experimental materials but with Z250 only 32%. With Z250 more than 50% conversion was achieved only below 1.1mm. Shrinkage was 3% and 2.5% for experimental materials and Z250, respectively. Early water sorption increased linearly, whilst strength and modulus decreased exponentially to final values when plotted versus square root of time. Maximum volumetric expansion increased linearly with CaP rise and balanced shrinkage at 10-20wt.% CaP. Strength and modulus for Z250 decreased from 191 to 158MPa and 3.2 to 2.5GPa. Experimental composites initial strength and modulus decreased linearly from 169 to 139MPa and 5.8 to 3.8GPa with increasing CaP. Extrapolated final values decreased from 156 to 84MPa and 4.1 to 1.7GPa. All materials containing CaP promoted hydroxyapatite precipitation.

SIGNIFICANCE

The lower surface of composite restorations should both be solid and have greater than 50% conversion. The results, therefore, suggest the experimental composite may be placed in much thicker layers than Z250 and have reduced unbounded cytotoxic monomer. Experimental materials with 10-20wt.% additionally have volumetric expansion to compensate shrinkage, antibacterial and re-mineralizing components and competitive mechanical properties.

Ester-free thiol-ene dental restoratives--Part B: Composite development

OBJECTIVES

To assess the performance of thiol-ene dental composites based on selected ester-free thiol-ene formulations. Further, to point out the benefits/drawback of having a hydrolytically stable thiol-ene matrix within a glass filled composite.

METHODS

Composite samples containing 50-65wt% of functionalized glass microparticles were prepared and photopolymerized in the presence of a suitable visible light photoinitiator. Shrinkage stress measurements were conducted as a function of the irradiation time. Degrees of conversion were measured by FT-IR analysis by comparing the double bond signals before and after photopolymerization. Mechanical tests were carried out on specimens after curing as well as after extended aging in water. Dynamic mechanical analysis was employed to track the changes in storage modulus near body temperature. The properties of the thiol-ene composites were compared with those of the BisGMA/TEGDMA control.

RESULTS

Depending on the resin type, similar or higher conversions were achieved in thiol-ene composites when compared to the dimethacrylate controls. At comparable conversions, lower shrinkage stress values were achieved. Although exhibiting lower initial elastic moduli, the thiol-ene composites' flexural strengths were found to be comparable with the controls. Contrary to the control, the mechanical properties of the ester-free thiol-ene composites were shown to be unaffected by extensive aging in water and at least equaled that of the control after aging in water for just five weeks.

SIGNIFICANCE

Employing non-degradable step-growth networks as organic matrices in dental composites will provide structurally uniform, tough materials with extended service time.

Pre-heating of high-viscosity bulk-fill resin composites: effects on shrinkage force and monomer conversion

OBJECTIVES

To investigate the influence of pre-heating of high-viscosity bulk-fill composite materials on their degree of conversion and shrinkage force formation.

METHODS

Four bulk-fill composite materials (Tetric EvoCeram Bulk Fill-TECBF, x-tra fil-XF, QuixFil-QF, SonicFill-SF) and one conventional nano-hybrid resin composite (Tetric EvoCeram-TEC) were used. The test materials were either kept at room temperature or pre-heated to 68°C by means of a commercial heating device, before being photoactivated with a LED curing unit for 20s at 1170mW/cm(2). Shrinkage forces (n=5) of 1.5-mm-thick specimens were recorded in real-time for 15min inside a temperature-controlled chamber at 25°C (simulating intraoral temperature after rubber dam application) with a custom-made stress analyzer. Degree of conversion (n=5) was determined at the bottom of equally thick (1.5mm) specimens using Fourier transform infrared spectroscopy. Data were analyzed with Student's t-test, ANOVA and Tukey's HSD post-hoc test (α=0.05).

RESULTS

Composite pre-heating significantly increased the degree of conversion of TECBF, but had no effect on monomer conversion of the other materials investigated. For each of the test materials, pre-heated composite generated significantly lower shrinkage forces than room-temperature composite. At both temperature levels, TECBF created the significantly highest shrinkage forces, and QF caused significantly higher shrinkage forces than both XF and TEC.

CONCLUSIONS

Both the composite material and the pre-cure temperature affect shrinkage force formation. Pre-heating of bulk-fill and conventional restorative composites prior to photoactivation decreases polymerization-induced shrinkage forces without compromising the degree of conversion.

CLINICAL SIGNIFICANCE

Composite pre-heating significantly reduces shrinkage force formation of high-viscosity bulk-fill and conventional resin composites, while maintaining or increasing the degree of monomer conversion, dependent upon the specific composite material used.

Resin-based composites show similar kinetic profiles for dimensional change and recovery with solvent storage

OBJECTIVES

To investigate the sorption, solubility, mass change and hygroscopic expansion (solvent swelling) of resin-composites after long term storage in different solvents.

METHODS

Eight materials were studied: two bulk-fill flowable materials (SDR and Venus bulk fill, V-BF), a packable bulk-fill material (Tetric Evoceram bulk-fill, TET-BF), a fiber reinforced material (Ever X posterior, EVX), a nano-hybrid conventional material (Tetric Evoceram, TET) and micro-hybrid conventional materials (G-aenial anterior, GA-P and posterior, GA-A). Three groups of disk shaped specimens were prepared using split stainless steel molds. Each group was stored, respectively, in: water, 75% ethanol/water and methyl ethyl ketone (MEK). The total storage time was 180 d plus a reconditioning time of 120 d. A non-contact laser scanning micrometer was used to measure the diametral changes.

RESULTS

Significant differences were found in the sorption and solubility of the materials. Generally, MEK stored specimens had the highest values followed by 75% ethanol/water then water. A similar trend was found with the mass and volume changes (except for EVX). V-BF showed the highest sorption (98.1μg/mm(3)) and solubility (10μg/mm(3)) after MEK storage. Mass and volume changes showed near-linear correlation, with high Pearson coefficients (0.86-0.99).

SIGNIFICANCE

Generally the materials were most greatly affected by MEK storage compared to the other two solvents. The glass-fiber-reinforced EVX, however, was most affected by water immersion. The pattern of change/recovery behavior of the materials, during solvent challenge, was similar to the pattern of viscoelastic creep/recovery behavior of resin-composite materials.

Sorption characteristics of oral/food simulating liquids by the dental light-cured nanohybrid composite Kalore GC

OBJECTIVE

This work presents the results obtained from the study of sorption/desorption process of some food/oral simulating liquids (FSLs) by the new marketed dental light-cured nanohybrid composite Kalore GC.

METHODS

The sorption/desorption process followed is recommended by ISO 4049:2009. The samples were immersed in various liquids proposed by ADA as FSLs, such as H2O, artificial saliva, EtOH, EtOH/H2O solution (75vol%) or C7H16, while the mass change for totally 30 days was recorded on defined time intervals. Afterwards the samples were put in dry desiccators at 37°C for the study of desorption process.

RESULTS

The weight percentage of sorption of the above mentioned FSLs by Kalore GC was determined; also the wt% of the desorbed liquid, the diffusion coefficient of sorption and desorption, the wt% solubility and the % volume increase due to the liquid sorption.

SIGNIFICANCE

The sorption characteristics of a dental composite depend both on composite structure and liquid. Ethanol/water and ethanol showed the highest effect on the determined characteristics. Then, the water and SAGF(®) saliva follows and finally the heptane solvent.

Investigation on the physical-mechanical properties of dental resin composites reinforced with novel bimodal silica nanostructures

The aim of this study was to investigate the influence of bimodal silica nanostructures comprising of SiO2 nanoparticles (SiO2 NPs, ~70 nm) and SiO2 nanoclusters (SiO2 NCs, 0.07-2.70 μm) on physical-mechanical properties of resin-based composites (RBCs). SiO2 NPs and SiO2 NCs were prepared with the Stöber method and the coupling reaction, respectively, then silanized and employed as fillers to construct RBCs using a mixture of bisphenol A glycerolate dimethacrylate (Bis-GMA) and tri(ethylene glycol) dimethacrylate (TEGDMA) as the organic matrix. Results showed that the properties of RBCs were influenced by the filler ratios of bimodal silica nanostructures, and the appropriate amount of SiO2 NPs could effectively increase the activating light efficiency and filler packing density of RBCs. Among all experimental RBCs, RBC 50-20 (SiO2 NPs:SiO2 NCs=50:20, wt/wt) presented the highest degree of conversion (71.6±1.1%), the lowest polymerization shrinkage (2.6±0.1%), and the enhanced flexural strength (104.8±4.4 MPa), flexural modulus (6.2±0.3 GPa), and compressive strength (205.8±14.3 MPa), which were improved by 44%, 19%, 28%, 48%, and 42% in comparison with those of RBC 0-60 (SiO2 NPs:SiO2 NCs=0:60, wt/wt), respectively. Besides, in vitro cytotoxicity evaluation of RBC 50-20 indicated its acceptable cytotoxicity. Although the best performance was achieved by commercial Z350 XT, the introduction of bimodal silica nanostructures might provide the enhanced physical-mechanical properties of RBCs, compared with those of RBC 0-60 reinforced with unimodal SiO2 NCs.

A comparison of stresses in molar teeth restored with inlays and direct restorations, including polymerization shrinkage of composite resin and tooth loading during mastication

Polymerization shrinkage of composites is one of the main causes of leakage around dental restorations. Despite the large numbers of studies there is no consensus, what kind of teeth reconstruction--direct or indirect composite restorations are the most beneficial and the most durable.

OBJECTIVE

The aim was to compare equivalent stresses and contact adhesive stresses in molar teeth with class II MOD cavities, which were restored with inlays and direct restorations (taking into account polymerization shrinkage of composite resin) during simulated mastication.

METHOD

The study was conducted using the finite elements method with the application of contact elements. Three 3D models of first molars were created: model A was an intact tooth; model B--a tooth with a composite inlay, and model C--a tooth with a direct composite restoration. Polymerization linear shrinkage 0.7% of a direct composite restoration and resin luting cement was simulated (load 1). A computer simulation of mastication was performed (load 2). In these 2 situations, equivalent stresses according to the modified von Mises criterion (mvM) in the materials of mandibular first molar models with different restorations were calculated and compared. Contact stresses in the luting cement-tooth tissue adhesive interface around the restorations were also assessed and analyzed.

RESULTS

Equivalent stresses in a tooth with a direct composite restoration (the entire volume of which was affected by polymerization shrinkage) were many times higher than in the tooth restored with a composite inlay (where shrinkage was present only in a thin layer of the luting cement). In dentin and enamel the stress values were 8-14 times higher, and were 13 times higher in the direct restoration than in the inlay. Likewise, contact stresses in the adhesive bond around the direct restoration were 6.5-7.7 times higher compared to an extraorally cured restoration. In the masticatory simulation, shear contact stresses in the adhesive bond around the direct composite restoration reached the highest values 32.8 MPa and significantly exceeded the shear strength of the connection between the resin luting cement and the tooth structure.

SIGNIFICANCE

Equivalent stresses in the tooth structures restored with inlays and in the restoration material itself and contact stresses at the tooth-luting cement adhesive interface are many times lower compared to teeth with direct composite restorations. Teeth with indirect restorations are potentially less susceptible to damage compared to those with direct restorations. Composite inlays also ensure a better seal compared to direct restorations. Polymerization shrinkage determines stress levels in teeth with direct restorations, while its impact on adhesion in indirectly restored teeth is insignificant.

An in vitro evaluation of wear and surface roughness of particulate filler composite resin after tooth brushing

OBJECTIVE

To evaluate the influence of tooth brushing on wear and surface roughness of four different particulate filler composite resins.

MATERIALS AND METHODS

Six specimens (2 mm thick and 8 mm in diameter) of each tested material (Filtek Z250-Microhybrid, SpectrumTPH3-Submicron hybrid, Filtek Z350XT Nanofiller and Filtek P90- Microhybrid) were prepared according to the manufacturer's directions. A brushing sequence of 5000, 10,000 and 20,000 cycles was performed for all the samples. A non-contact profilometer was used to determine average surface roughness (Ra) and wear of the material assessed using an analytic electronic balance at baseline and each cycle interval. The data obtained were analyzed using one-way ANOVAs and post-hoc multiple comparison tests. Paired t-test was used for comparisons between cycle intervals for each material. Analyses with scanning electron microscopy (SEM) were also performed.

RESULTS

The resin composite Filtek P 90 presented an increase in percentage weight loss after final toothbrushing cycles over the rest of the materials. Brushing significantly increased roughness (Ra) for all composites. Filtek Z250, after brushing, was significantly rougher than the other resins followed by Filtek P 90, Spectrum TPH 3 and Filtek Z350 XT. However, SEM images indicated severe change in surface topography of 'sub-micron hybrid' specimen compared to each other after tooth brushing.

CONCLUSIONS

Wear and surface roughness increased with each cycle interval for all the materials and one composite resin demonstrated a higher increase in surface roughness than the other three tested brands of composite resins. Not much difference was observed in the weight loss between tested samples.

Water Sorption, Solubility, and Color Stability of Giomer Restoratives

OBJECTIVES

This study compared the color stability, water sorption, and solubility of a giomer composite and two nanohybrid composite resins.

MATERIALS AND METHODS

Disc-shaped specimens (1-mm thickness × 15-mm diameter) of a giomer (Beautifil II, Shofu, Kyoto, Japan) and two nanohybrid (Filtek Z550, 3M ESPE, St. Paul, MN, USA; Tetric N-Ceram, Ivoclar Vivadent, Schaan, Liechtenstein) composites (N = 10) were prepared. Baseline color measurements were taken, and specimens were immersed in water for 28 days. Following immersion, color values were remeasured, and color-change values (ΔE) were calculated. Water sorption and solubility were assessed by mass gain or loss after storage in water for 28 days. Data were analyzed with one-way analysis of variance and Tukey's post-hoc tests (p = 0.05). Pearson's correlation test was used to assess possible correlations between water sorption and solubility, water sorption and color stability, and solubility and color stability (p = 0.05).

RESULTS

Water sorbtion (%) and color change (ΔE) varied significantly among groups, with Beautifil II exhibiting the highest values (p < 0.001). No statistically significant differences were observed in water solubility values among the groups (p = 0.661); however, a linear, positive correlation was detected between solubility and discoloration (r = 0.368, p = 0.046).

CONCLUSION

Water sorption and discoloration values of the giomer composite group were significantly higher than those of the nanohybrids tested.

CLINICAL SIGNIFICANCE

The high levels of water sorption and discoloration of giomer composites are likely to have an adverse effect on esthetic restorations.

Three-Dimensional Human Cell Cultures for Cytotoxicity Testing of Dental Filling Materials

OBJECTIVES

So far, bovine immortalized pulp cells have been used as three dimensional cultures for cytotoxicity testing of filling materials in the dentin barrier test (DBT). In this study, the use of human pulp-derived cells was evaluated, which would better simulate the clinical situation, and a composite material with a new resin base was tested.

MATERIALS AND METHODS

SV40-transfected human pulp cells (tHPC) were cultured in hydrogels (fibrin, peptide, collagen) and mechanical properties and cell viability (MTT or WST-1) were determined. For cell cultures in collagen, a four week - proliferation assay was performed (WST-1). After 14 days of three-dimensional culture in collagen, tHPC were introduced into the DBT with 200 µm dentin disks. After a 24-hour incubation under perfusion (0.3 ml/h), the following materials were applied according to the manufacturers' instructions (1) President (Coltene): negative (non-toxic) control, (2) CaGPG14 (ISO 7405): positive (toxic) control, (3) Tetric EvoCeram (Ivoclar Vivadent) with Clearfil SEBond (Kuraray, reference material), (4) N´Durance (Sepodont, test material), (5) N´Durance with Clearfil SEBond. Cell viability was determined after 24-hour incubation (WST-1). The percentage of relative viability was calculated (negative control=100%) and statistically analyzed (Kruskal-Wallis-test, p<0.05).

RESULTS

Fibrin and peptide gels had insufficient mechanical properties for the DBT Collagen and appeared suitable for three-dimensional cell culture of tHPC for up to 21 days. The cultures could be transferred to the DBT device and results for controls were similar to previous tests with bovine cells. The DBT using tHPC in the collagen showed no statistically significant difference between the test material with and without the adhesive and the reference resin composite.

CONCLUSIONS

tHPC in collagen can replace bovine cells in the DBT. The tested filling material is not likely to cause pulp damage, if the pulp is covered by an intact dentin layer.

Characterization of a low shrinkage dental composite containing bismethylene spiroorthocarbonate expanding monomer

In this study, a novel dental composite based on the unsaturated bismethylene spiroorthocarbonate expanding monomer 3,9-dimethylene-1,3,5,7-tetraoxa-spiro[5,5]undecane (BMSOC) and bisphenol-S-bis(3-meth acrylate-2-hydroxypropyl)ether (BisS-GMA) was prepared. CQ (camphorquinone) of 1 wt % and DMAEMA (2-(dimethylamino)ethyl methacrylate) of 2 wt % were used in a photoinitiation system to initiate the copolymerization of the matrix resins. Distilled water contact angle measurements were performed for the wettability measurement. Degree of conversion, volumetric shrinkage, contraction stress and compressive strength were measured using Fourier Transformation Infrared-FTIR spectroscopy, the AccuVol and a universal testing machine, respectively. Within the limitations of this study, it can be concluded that the resin composites modified by bismethylene spiroorthocarbonate and BisS-GMA showed a low volumetric shrinkage at 1.25% and a higher contact angle. The lower contraction stress, higher degree of conversion and compressive strength of the novel dental composites were also observed.

Water Aging Reverses Residual Stresses in Hydrophilic Dental Composites

Dental composites develop residual stresses during polymerization due to shrinkage. These stresses may change with time because of relaxation and water sorption in the oral environment. This phenomenon is likely dependent on the composition of the materials, specifically their hydrophilic characteristics, and could result in deleterious stresses on restorative materials and tooth structure. The purpose of this experiment was to use the thin ring-slitting method to compare the residual stress generated within composite materials of varying hydrophilicity when aged in wet and dry conditions after polymerization. Water sorption, solubility, elastic modulus, and residual stresses were measured in 6 commercial composites/cements aged in water and dry conditions. The self-adhesive resin cement showed the highest water sorption and solubility. All composites showed initial residual contraction stresses, which were maintained when aged dry. Residual stresses in 2 of the self-adhesive cements and the polyacid-modified composite aged in wet conditions resulted in a net expansion. This experiment verified that residual shrinkage stresses in dental composites can be reversed during aging in water, resulting in a net expansion, with the effect directly related to their hydrophilic properties.

Polymerization development of "low-shrink" resin composites: Reaction kinetics, polymerization stress and quality of network

OBJECTIVES

To evaluate "low-shrink" composites in terms of polymerization kinetics, stress development and mechanical properties.

METHODS

"Low-shrink" materials (Kalore/KAL, N'Durance/NDUR, and Filtek P90/P90) and one control (Esthet X HD/EHD) were tested. Polymerization stress (PS) was measured using the Instron 5565 tensometer. Volumetric shrinkage (VS) was determined by the ACTA linometer. Elastic modulus (E) and flexural strength (FS) were obtained by a three-point bending test. Degree of conversion (DC) and polymerization rate (Rp) were determined by NIR spectroscopy (6165cm(-1) for dimethacrylates; 4156 and 4071cm(-1) for P90). Photopolymerization was performed at 740mW/cm(2)×27s. Glass transition temperature (Tg), degree of heterogeneity and crosslink density were obtained in a DMA for the fully cured specimens. Analysis of extracts was done by (1)H NMR. Data were analyzed with one-way ANOVA/Tukey's test (α=0.05).

RESULTS

The control presented the highest shrinkage and Tg. P90 showed the highest modulus, and NDUR demonstrated the highest conversion. The polymerization rates were comparable for all materials. NDUR and KAL had the highest and the lowest network homogeneity, respectively. The multifunctional P90 had the highest crosslink density, with no difference between other composites. The control had the greatest stress development, similar to NDUR. Crosslinking density and polymer network homogeneity were influenced by degree of conversion and monomer structure.

SIGNIFICANCE

Not all "low-shrink" composites reduced polymerization stress. P90 and NDUR had no leachable monomers, which was also a function of high crosslinking (P90) and high conversion (NDUR).

The relationship between cyclic hygroscopic dimensional changes and water sorption/desorption of self-adhering and new resin-matrix composites

OBJECTIVES

This study evaluated the relationship between mass changes and hygroscopic dimensional changes during water sorption/desorption cycles in new resin composites.

METHODS

A silorane posterior composite (Filtek(®) Silorane, FS), two micro-fine hybrid composites (GC Gradia Direct Anterior, GDA; GC Gradia Direct Posterior, GDP), a universal composite (GC Kalore, GCK), and a self-adhering flowable composite (Vertise(®) Flow, VF) were evaluated. 25 (n=5) disk specimens (15mm×2mm) were prepared according to ISO 4049. Water sorption was measured gravimetrically. Hygroscopic expansions were measured by a laser micrometer regularly during 150 d water storage and 40 d recondition periods, all at 37°C. Data were analyzed by repeated measures ANOVA, one-way ANOVA and Tukey's post hoc test (p<0.05).

RESULTS

Mass changes after 150 d water immersion ranged from 0.68% (±0.02) for FS to 2.83% (±0.11) for VF and the corresponding hygroscopic expansions were from 0.74% (±0.05) for FS to 4.79% (±0.18) for VF. The differences were significant for all materials (p<0.001), except mass changes between GCK and GDP, as well as hygroscopic changes between GCK and GDA. The relationship between hygroscopic expansions and mass changes was initially non-linear and then tended toward linear behavior. But at the late stage of water sorption the hygroscopic expansion of GCK and VF was slightly sigmoidal with respect to their mass changes.

SIGNIFICANCE

Relationships between hygroscopic expansion and mass change were determined for some diverse resin-matrix composites. The initial non-linearity for all materials suggests a lower expansion rate due to occupancy of internal free volume by water ingress. The silorane composite FS showed statistically the lowest mass change and hygroscopic dimensional change.